Constant exotropia is uncommon during the first year of life.We investigated characteristics, surgical outcome and associated ocular abnormalities in patients who had an exodeviation during the first year of life. The charts of 18 patients who were diagnosed as congenital exotropia before 1 year old were reviewed.We etrospectively analyzed 10 healthy patients who did not have associated systemic or ocular abnormalities and were followed for at least 3 months after surgery. The mean follow-up period was 1.2 years[range, 3 months to 3.5 years]and all of them had an exodeviation of 25 prism diopter[PD]or more[mean, 37.5PD, SD 10.6PD].Preoperative DVD and inferior oblique muscle overaction were found in 1 patient respectively. Surgery was performed in 9 cases and botulinum toxin was injected in 1 case.Seven patients[70%]showed stable alignment within 10PD with one operation and one patient required reoperation.Postoperative dissociated vertical deviation and inferior oblique muscle overaction were found in each 1 patients. Congenital exotropia has large deviation and may be associated with inferior oblique muscle overaction or dissociated vertical deviation as infantile esotropia and has stable alignment with single operation.But unlike infan-tile esotropia, nystagmus is extremely rare.
Botulinum Toxins ; Esotropia ; Exotropia* ; Follow-Up Studies ; Humans

Background: Stomach cancer is the most commonly diagnosed malignant tumor in Korea. Early detection by mass screening very important to increase survival rate of stomach cancer, because the prognosis of early gastric cancer is excellent, and specific symptoms and physical findings are rare with early gastric cancer. Methed: 1865 car manufacturing company employees were examinined by gastrofiberscopy at a dispensary of the company from May 6, l992 to July 13, 1992. Results: 1. Number of cases with normal finding was 1262(67.7%), gastritis 422(22.6%), gastric ulcer 47(2.5%), gasrtric cancer 4(0.2%), duodenitis 39(2.1%), duodenal ulcer 63(3.4%), combined ulcer(gastric & duodenal) 2(0.1%,), post operative state 6(0.3%), and others 4(0.3%) in total 1865 examinees. 2. Of 422 cases with gastritis, cases with superficial gastritis were 171 (9.2%), atrophic gastritis 138(7.4%), erosive gastritis 94(5.0%) and hemorrhagic gastritis 19(1.0%). 3. Of 4 cases with stomach cancer, 1 case was advanced stomach cancer and 3 cases were early gastric cancer(two cases of IIc and one case of IIc+III) by macroscopic classification. Conclusion: Mass screening provides an excellent opportunity to detect gastric cancer in populations without symytoms or with nonspecific symptoms. It should be recommended to undergo screening exam for high risk group of stomach cancer.
Classification ; Duodenal Ulcer ; Duodenitis ; Gastritis ; Gastritis, Atrophic ; Korea ; Mass Screening* ; Prognosis ; Stomach Neoplasms* ; Stomach Ulcer ; Stomach* ; Survival Rate

Thirty one children with horizontal strabismus in age less than 10 years were treated with botulinum toxin type A(Botox) injection of extraocular muscles. We have analyzed the effects and complications of injection in twenty five patients for whom follow-up of 3 months or more was available. Preinjection alignment was 25+/-11 prism diopter(PD) in exotropia and 35+/-10PD in esotropia. The average time of maximal effect was 1 week after injection and the average time to achieve orthotropia 2 to 3 months after injection. At three months after injection, the alignments in fifteen patients(60%) were 10 prism diopter(PD) or less, in eight between 10 and 20PD, and in two more than 20PD. Success rate was high when limitation of eye movement was obvious(> OR = -2) at 1 week after injection. The most common complications were ptosis presented in fifteen patients(60%), subconjucntival hemorrhage in eight, abnormal head position in seven, vertical strabismus in seven and disorientation in one. Initial injection of botulinum toxin showed poorer results compared to surgery in childhood horizontal strabismus but did not show severe complications except undercorrection. Toxin injection can be an alternative choice of strabismus management but more prolonged follow-up will be needed.
Botulinum Toxins* ; Child ; Esotropia ; Exotropia ; Eye Movements ; Follow-Up Studies ; Head ; Hemorrhage ; Humans ; Muscles ; Strabismus*

A total of 377 pregnant women, 43 pelvic tumor patients and 80 of multiphysic health center persons as controls were examined by indirect latex agglutination test in order to evaluate Toxoplasma antibody titers at Kang-Nam St. Mary's Hospital in Seoul. Throughout this survey, 1:32 or more titers of diluted sera were regarded as positive. The 337 samples of test sera in pregnant women showed negatives in 319 cases (84.6 percent), 1:2 in 44 cases (11.7 percent), 1:4 in 9 cases (2.4 percent), 1:8 in 2 cases (0.5 percent), 1:16 in 1 case (0.3 percent) and 1:32 in 2 cases (0.5 percent) respectively. The 43 samples of test sera in pelvic tumor patients showed negatives in 29 cases (67.4 percent), 1:2 in 8 cases (18.6 percent), 1:4 in 1 case (2.3 percent), 1:16 in 2 cases (4.7 percent), 1:32 in 1 case (2.3 percent) and 1:128 in 2 cases (4.7 percent). The 80 samples of test sera in multiphysic health center persons as controls negatives in 56 cases (70.0 percent), 1:2 in 19 cases (23.8 percent), 1:4 in 3 cases (3.8 percent), 1:8 in 1 case (1.3 percent) and 1:128 in 1 case (1.3 percent). Among total 420 study cases, 5 cases (1.2 percent) showed positives , and they were 2 cases (0.5 percent) of pregnant women and 3 cases (7.0 percent) of pelvic tumor patients. One case (1.3 percent) out of 80 control sera showed positive result.
parasitology-protozoa ; Toxoplasma gondii ; diagnosis ; immunology

No abstract available.
Staphylococcal Scalded Skin Syndrome*

Optic disc can be analyzed with computerized optic nerve head analyzer or confocal scanning laser ophthalmoscope because optic disc has 3-dimensional structure. But the great cost of these instruments makes their utility for the average ophthalmologist unlikely. We measured optic discs with personal computer and stereophotograph and report as follows. Seventy-six optic discs of 76 normal subjects[61 men, 15 women; mean age: 25.5 years] were evaluated by stereoscopic optic disc photography. The area and length were measured by a computer graphic program and converted to absolute unit with Littmann's formula. The mean vertical disc diameter[1.94+/-0.24 mm], the mean horizontal disc diameter[1.67+/-0.23 mm], the mean vertical cup diameter[1.03+/-0.20 mm], the mean horizontal cup diameter[0.96+/-0.19 mm], the mean disc area[2.64+/-0.62 mm2], the mean disc circumference length[5.84+/-0.67 mm], the mean cup area[0.82+/-0.30 mm2], the mean cup base area[0.22+/-0.17 mm2], the mean cup slope area[0.60+/-0.21 mm2] and the mean rim area[1.82+/-0.41 mm2] were evaluated. The new technique to measure optic disc with stereophotograph and personal computer is thought to be a useful method to understand threedimensional structure of optic disc with relatively simple instruments.
Computer Graphics ; Female ; Humans ; Male ; Microcomputers ; Ophthalmoscopes ; Optic Disk ; Photography

We conducted a prospective study to compare MMC subconjunctival injection with MMC soaking for surgical outcome and postoperative complications as an adjunct to trabeculectomy in eyes with glaucoma. Eleven patients with bilateral glaucoma had undergone primary trabeculectomy with adjunctive subconjunctival mitomycin-C injection in one eye[Group I] and primary trabeculectomy with subconjunctival mitomycin-C soaking in the other eye[Group II]. Minimal follow-up period was 6 months and mean follow-up period was 12.8 months. Preoperative mean IOP was 35+/-10.9 mmHg in the group Iand 33+/-14.4 mmHg in the group II, and there was no statistical significance. Postoperative mean IOP at 1, 3, 6 months were 13+/-2.3, 13+/-3.1, 13.6+/-2.9 mmHg in the group I, and 11.3+/-3.3, 12.2+/-3.4, 12.9+/-2.7 mmHg in the group IIand no statistical significance. Each of ten eyes[91%] in both groups achieved intraocular pressure of less than 21 mmHg and good bleb formation without any medication. Postoperative complications were transient hyphema[18% in the group I, 9% in the group II], cystic bleb[9% in the group I, 27% in the group II] and shallow anterior chamber[9% in the group II]. Postoperative corneal endothelial cell density per square millimeter averaged 2, 221+/-306/mm2[mean+/-standard deviation] in the group I and 2, 195+/-272/mm2in the group II and there was no statistical significance. The rates of surgical success and postoperative complications were similiar in the two groups. Subconjunctival injection has similar effect to soaking method. This method enables us to have accurate control of concentration and amount of MMC, and thereby reduces complications and improves surgical outcomes in trabeculectomy.
Blister ; Endothelial Cells ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Prospective Studies ; Trabeculectomy*

A papillary adeno-carcinoma of the renal pelvis is very rare tumor and mostly diagnosed by histopathologic findings. A 10-years-old female was admitted to Fatima Hospital with Rt. flank pain and intermittent gross hematuria.Herein, we report a case of papillary adeno-carcinoma of the renal pelvis.
Adenocarcinoma ; Female ; Flank Pain ; Humans ; Kidney Pelvis*

PURPOSE: To report two cases of trabeculectomy with biodegradable collagen material conducted on two post-vitrectomy patients. CASE SUMMARY: The first patient was a 43-year-old woman with uncontrolled increased intraocular pressure (IOP) after pars plana vitrectomy with scleral buckling for diabetic retinopathy and vitreous hemorrhage. Another patient, a 28-year-old woman with aphakia, also had uncontrolled increased IOP after pars plana vitrectomy with encircling scleral buckling for retinal detachment. For both of these patients, we performed trabeculectomy using mitomycin C and recently developed biodegradable collagen matrix. In the first case, the IOP was increased three months after the surgery, for which needling was done. After needling, the IOP was well controlled in the range of 16 to 19 mmHg up to eight months postoperatively with stilling anti-glaucomatous eyedrops (Cosopt(R), Xalatan(R)). In the second case, IOPwas increased one week after the surgery, but it was well controlled between 14 to 21 mmHg up to nine months postoperatively with anti-glaucomatous eye drops (Combigan(R)). CONCLUSIONS: Biodegradable collagen matrix can possibly reduce the surgical failure of trabeculectomy and it is especially suitable for high risk patients when combined with anti-metabolic agents like MMC.
Adult ; Aphakia ; Collagen ; Diabetic Retinopathy ; Female ; Humans ; Intraocular Pressure ; Mitomycin ; Ophthalmic Solutions ; Retinal Detachment ; Scleral Buckling ; Trabeculectomy ; Vitrectomy ; Vitreous Hemorrhage ; Wound Healing

This study was designed to evaluate the partially purified antigens which were fractionated from crude extract of Paragonimus westermani and to monitor the enzyme-linked immunosorbent assay (ELISA) in experimental cat paragonimiasis during the course of infection as well as before and after chemotherapy. Crude extract of 6-month-old adult P. westermani was fractionated to 5 antigens by successive applications of ammonium sulfate precipitation, ion exchange chromatography and gel filtration. And the cats, 10 in each group, were infected with 60, 30, 15, and 5 metacercariae, then the half of each group was treated with praziquantel 2 times in one day of 100 mg per kilogram of weight on 150 days after the infection. Sera were collected every 10 days. ELISA was performed with the concentration of 2 microgram/ml antigen, 100 times diluted sera and 1,000 times diluted alkaline phosphatase conjugated anti-cat IgG. The results were as follows: Absorbance by ELISA with proteins precipitated by differential concentration of ammonium sulfate was the highest at 51-65 per cent precipitate (PA2), followed by 0-50 per cent precipitate (PA1), 66-80 per cent precipitate (PA3), and 81-90 precipitate (PA4). Unprecipitated protein over 90 per cent ammonium sulfate (PA5) showed the lowest antigenicity. Fractionation of PA1, PA2, and PA3 through the DEAE-cellulose column did not differentiate the antigenic proteins. By passing through the Sephadex G-200 column, PAl and PA2 were fractionated to high molecular weight proteins and those of low molecular weight which showed high absorbance by ELISA (PA1-I, II and PA2- I, II). But PA3 was shown to have a fraction of high molecular weight proteins (PA3-I) which showed high antigenicity. SDS-polyacrylamide gel electrophoresis of PA1-I, PA1-II, PA2-I, PA2-II, PA3-I, and crude extract was performed. Fraction PA1-I was composed of proteins which had the molecular weight of 270 kilodaltons (KD) to 196 KD; of them 220 KD protein was major band. Fraction PA2- I was composed of 255-225 KD, and PA3-I, 255-240 KD, respectively. Fraction PA1-II and fraction PA2-II consisted of 30 KD proteins. Absorbance by ELISA began to increase within 10-20 days after the infection and reached the highest on 140-180 days, then made plateau thereafter. Absorbance by ELISA decreased after praziquantel treatment. In 60 metacercariae infection group, the absorbance had been decreasing, but remained within the positive range during observation period, while those of 30, 15, and 5 metacercariae infection groups turned to negative range. Fraction PA1-II showed the highest antigenicity in ELISA, then fraction PA2-I, fraction PA1-I , fraction PA2-II, fraction PA3-I and crude extract followed. In early phase of infection, the absorbance of fraction PA1-II showed more rapid increase than those of the other fractions and it came to positive range at 20-30 days after infection.
parasitology-helminth-trematoda ; immunology ; enzyme-linked immunosorbent assay ; Paragonimus westermani ; antigen